| NPI | 1578559522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0041810) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: MD D0041810) |
| 2085N0904X Radiology, Nuclear Radiology (Licence: MD D0041810) | |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2012-11-06 |